BMJ  2007;335:839 (27 October), doi:10.1136/bmj.39374.370463.BE

Letters

Surgical mortality

Media attack

The first 150 words of the full text of this article appear below.

We are concerned that publishing non-risk stratified cardiac surgical mortality statistics may have adverse effects on surgical teams, bereaved parents, and people with children to be treated at targeted centres.¹ We support data collection to maintain clinical standards, but hospital episode statistics are unreliable for measuring mortality and unsuitable for comparison between centres.

Half of units will be below the mean in rankings for surgical mortality. The lay press often interprets "below average" as inadequate or incompetent. Non-risk stratified death rates collected by the UK congenital cardiac audit database (CCAD) were recently published. These are difficult to understand for the lay reader. The Scottish press castigated the centre in Glasgow, whose overall survival rate was 95.9% (UK average 96.7%).² Comments included:

•"Death rates for children's heart operations are significantly higher than the rest of the UK" (untrue)

•"This is totally unacceptable and I am very concerned . . . The . . . [Full text of this article]

¹ Department of Cardiac Surgery, Oxford Radcliffe Hospital NHS Trust, Oxford OX3 9DU, ² Department of Paediatric Cardiology, John Radcliffe Hospital, Headington, Oxford OX3 9DU

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